Visual indicating apparatus for determining correction of postural foot alignment



Patented Dec. 26, 1950 UNITED STATES PATENT OFFICE VISUAL INDICATINGAPPARATUS FOR DE- TERMINING CORRECTION OF POSTURAL FOOT ALIGNMENTClaims.

This invention relates in general to apparatus for visibly indicatingwhether or not there is misalignment of the feet from proper posturalposition, and is particularly useful for physicians, surgeons,orthopedists, and even ordinary skilled shoe or footwear repairers,rebuilders, and others, in more readily, easily and accuratelydetermining the amount of misalignment of a persons foot from the normalwalking angle, and the amount of elevation required for the sole andheel of the shoe or footwear to correct an incorrect walking angle tothe normal walking angle, in the course of walking.

More specifically, the present invention is directed to the provision ofapparatus having a stationary support for the sole of one of the feet,and a central pivotally-mounted support in the same horizontal plane forthe sole of the other foot of a patient standing with normal stance, inconjunction with a member providing a straight line of sight, preferablya vertical straight line of sight, mounted in position to confront andcorrespond with a straight line passing through the patella and the headof the femur, and extending down along the limb on the pivotallymountedsupport, from the knee along the crest of the tibia or shin bone, downthrough the center of the foot. The member providing the straight lineof sight is vertically adjustable to accommodate persons of varyingheights, and is preferably also provided with an inner extension, in theform of a pendulent plumb, or of upper and lower pointers, reaching inclosely to the shin bone, for greater accuracy in determining alignment.

The pivotally mounted support is provided with actuating means forrotatably adjusting the support, to rotate a misaligned foot relative tothe tibia and figula, patella and head of the femur of the patientslimb, to bring it into alignment with a straight line passing throughthe patella and femur, which restores the normal walking angle incorrection of an incorrect anatomical walking angle. Means are alsoprovided for accurately indicating the amount of rotation of the foot,and hence the degree of elevation required in correction of theincorrect walking angle. Means are also provided for holding thepivotally-mounted support against accidental rotation while the patientsare adjusting themselves thereon, until the operator has in hand thecontrol of the actuating means.

In one embodiment, the apparatus also provides an adjustable grippingmeans for centering and amxing the knee in set position, in confrontingrelation with the member providing the straight line of sight. In thisembodiment, the member providing the straight line of sight comprisesupper and lower inwardly extending pointers in vertical alignment incloser proximity to the center of the patella and over the top of thetoes of a patients limb, when standing with their normal stance on theapparatus or device.

In the preferred embodiment of the invention, the aforesaid adjustablegripping device is, however, omitted, and the inward extension of themember providing a straight line of sight comprises instead, a pendulentplumb having an outwardly extending plumb bob arranged to extendoutwardly over, and in close proximity to the toes in horizontalalignment with the straight line of sight member, and more particularlyin the same vertical plane as the plumb.

More especially, the present invention is directed to apparatus for morefacilely determining with greater accuracy, the degree of elevation, andhence the thickness of elevation, required in embodying the invention ofmy 00- pending application Serial No. 676,691, filed June 14, 1946,entitled Walking Angle Corrective Footwear and Method, which providesfor correcting the normal walking angle of humans in the course ofwalking, b elevating the medial side of the shoe or other footwear withan elevated outer foresole and heel by means of separate or integrallyformed partial outer lift portions, in or on the bottom of the outerforesole and heel of footwear of the patient, so as to effect anadjustment of the bones of the medial side of the foot by the singleupward motion of the bones, unaccompanied by either attendant rockingmotion of the upper leg members, or twisting of the foot or shoe, beforethe weight of the wearer is transmitted to the foot by the weightbearing members of the leg above the foot in the process of ambulation,thus correcting the walking angle up through the patella, the head ofthe femur, and finally the spinal column.

The amount of elevation is corrected to each individuals need.

The lateral margin of the tibia if extended downward, passes through thecenter of the foot or slightly lateral to center on the small toe side.This is the normal walking angle.

If this line passes medial to center or to the big toe side, the personhas an incorrect walking angle, which causes extra strain on the musclesand ligaments of the entire lower extremity, eventually throwing thewhole skeletal system out of balance.

Normally, the outer portion of the longitudinal arch of the foot is verylow and almost rests on the ground. The inner part is high and onlytouches the ground behind. The inner border of the foot is naturallystraight or concave inward when weight is borne. V A vertical linedropped from the head of the femur through the' patella and along thecrest of the tibia'should pass normally through the secondinter-metatarsal space (between the third and fourth toes, from thelittle toe side).

Alteration of the correct walking angle, such as occurs in the case offlat foot results in the forefoot being deflected laterally, the archdrops and becomes flattened, the inner border, which should normall showa slight concavity, is re placed by convexity, and the vertical linedropped from the head of the femur through the patella along the crestof the tibia, instead of normally passing through the secondintermetatarsal space (between the third and fourth toes), passesinternal to this space, toward the big toe side. This throws the wholeskeletal system out of balance. I

In the development of the invention of my aforesaid copendingapplication Serial No. 676,- 691, it was found that the employment ofwedge shaped partial lifts as inter-lifts which are intermediate theupper surface of the bottom lifts g of the fore-outsole and heel, andthe bottom surface of the insole, with the wedges restricted to excludethe shank, and decreasing in thickness from the medial side to thecenter of the shoes outer sole structure, the incorrect walking angle iscorrected to the acknowledged anatomical normalv walking angle, withoutany accompanying rocking or twistin action of the shoe, foot, or limp,and the balance of skeletal system restored to normal.

In my copending application, for proper fitting in a relatively shortperiod of time, such as fifteen minutes to a half hour, and forfashioningfootwear to the specific needs of dififerent individuals,under simple technique, which can, be

to, determine where the vertical line passes,

through the foot.

When the vertical line passes, medial to cen: ter, or to the big toeside (from the, space between the third and fourth toes, counting fromthe little toe side), partial lifts of the invention, of the estimatedrequired height, are fitted to or prescribed for, the footwear, of thethickness,

necessary to shift the foot (rotate it relative to the tibia) until thevertical line of sight shifts laterally toward the little toe side, topass through the space between the third and fourth toes, which is theacknowledged anatomical center of the foot, or even slightly lateral tothis center on the small toe side, which restores the normal walkingangle and thus the center of gravity to the whole skeletal system.

The present invention, however, is primarily directed to providinginstead, a simple mechanical apparatus for attaining the same end with 4greater accuracy and certainty, and more readily and easily, as well aswith precision. H g

In addition to the general objects recited above, the invention has forfurther objects such other improvementsand such other operative advantages or results as may be found to obtain in the structure and methodhereinafter described and claimed.

In the accompanying drawing, forming a part of this specification, andshowing, for purpose of exemplification, preferred form and manner ofembodying and practicing the present invention:

Figure l is a top plan view of apparatus e'mbodying the preferred formof the invention;

Figure 2 is a front elevational view of the same;

Figure 3 is a vertical cross-sectional view, with parts shown inelevation, and taken on the line 3-3 of Figure 1;

Figure 4 is a diagrammatic view, in top plan, of another manner ofembodying the present invention;

Figure 5 is a diagrammatic view, in side elevation, of the sameapparatus shown in Figure 4;

Referring to the drawings, there is shown the preferred embodiment ofthe invention in which is provided two side-by-side stationary supports,

H, i 2 with an intermediate centrally pivotally mounted support l3,whereon the patient stands with normal stance, with the right foot onstationary support ll While the left foot is on the adjustable supporti3, and With the left foot on the stationary support [2 while the rightfoot is on the adjustable support l3, during theoperation of determiningthe amount of deviation of the feet from that requiredfor the normalwalking angle, and hence the amount of elevation required of the solesand heels of footwear, in accordance with the invention of my aforesaidcopending application, to correct an incorrect walking angle.

The apparatus comprises a base [4 in the form of a casting, in which thesupports H, l2 and it are all disposed in one and thesame horizon talplane. The intermediate, adjustable support 53, is mounted for pivotalmovement on a centrally disposed shaft l5, extending longitudinally ofthe support l3,'and disposed centrally on the transverse axisof thesupport l3. The shaft 15 is mounted for rotation in bearings I! in thebase it, and is provided at its forward end with an actuating means [8,for adjusting the support 53 while the patient is standing thereon, toalign the foot with the tibia in accordance with the anatomicallyacknowledged normal walking angle.

As shown, this actuating means [8; comprises a gear [9; on the front endof the shaft l5 with which meshes a mitre gear 29 at-the lower end of ashaft 2! mounted for rotation about avertical axis in a bearing surfacein the base M; For rotation of the shaft 2|, a handle 22 is securedthereto, as at 23, and there is affixed therewith a pointer Z i Whichpartakes of the same movement of the rotation oft he handle and shaft21, A scale It is mounted on the base I l in relation to the pointer 24,which scale it is marked'off to indicate the degree or amount ofrotation of the actuating means l8, and hence the degree of movement ofthe left foot, when the handle 22 is turned to the right(anti-clockwise) in tilting the right side of the adjustable support 13upward, to raise the medial (inside) of the left foot of a patient whenstanding on the adjusta ble support L3; and likewise for the right footwhen the handle 22 is turned to the left (clockwise) to raise the medial(insidel' of the right" foot.

To prevent the adjustable support from tilting when a patient isstanding with one foot there.- on, or preparing to do so, and until theoperator has control of the handle 22, means are provided in the form ofan adjustable bolt 26 which is. threaded through the handle lever 22 asat 21, and provided with wings 28', for facility in tightening andloosening the bolt 26, to prevent and permit, respectively, the turningof the actuating means i8, and thus the adjustable support 13, while thepatient is standing thereon.

Mounted on the base M, in vertical alignment withthe axis of rotation l5of the adjustable support I3 is a member 29 providing a straight line ofsight. This member 29 is mounted therein so as to have its straight lineof sight in position to confront and correspond with a straight lineextending downwardly from the knee of the limb of a patient, whilestanding on the adjustable support I3, to the sole of the foot on thesupport l3, as for instance, to provide a vertical line confronting andcorresponding with a vertical line dropped from the head of the femurthrough the patella and extending downwardly along the crest of thetibia, or shin bone, and projecting on down through the foot.

Preferably the straight line-of-sight provided by the member 29 takesthe form of a vertical line in the member 29, together with an inwardextension in the same vertical plane, which extension extends inwardlyinto closer proximity to the patients limb and foot, when standing withnormal stance on the support I I, l2, Hi.

In the preferred form of the invention, this inward extension takes theform of a pendulent.

plumb 39 freely pivotally supported at the upper end as at 32 from ahorizontal member 33, and provided at its lower end with an outwardlyprojecting plumb-bob 34, arranged to extend closely over the toes of thepatient.

The straight line-of-sight member 29 and the plumb 39 are verticallyelongatable, to accommodate patients of varying heights. For thispurpose they are composed of telescopic members and provided with setscrews 35 and 3B for firmly fixing them in vertically adjusted position.

In another embodiment, as shown merely diagrammatically, inFigures 4 and5, in lieu of the pendulent plumb, there is provided as the innerextension, upper and lower pointers 37 and 38. The upper 31 being longerto project into abutting relation with the limb on the adjustablesupport l3 in the region of the patella, or close thereto, in verticalalignment with the centers of the patella and the head of the femur. Thelower pointer 38 is shorter and projects closely over the top of thetoes in the same vertical plane as the upper pointer 31.

The invention also embodies means 39 for affixing the limb of a patientin proper alignment with the straight line-of-sight provided by themember 29. As shown in Figures 4 and 5, this comprises a verticallyextensible telescopic member 49, provided with a set screw 4|, whichmember 39 is mounted at its lower end in fixed relation in the base Itand is provided at its upper end with means 42 for clamping the knee ofthe patient in fixed position relative to the straight lineof-sight,when on the support l3.

v:This knee clamping member is vertically adjustable at 42, andcomprises two arms 44, 45 which extend around the limb, and which armsare provided with bearings 46 (usually provided 6. with a soft pad)a'djustably'inounted'at 47 for centering the limb by clamping.

In the preferred form of invention, as shown in Figures 1-3, the kneeclamping feature 42 isomitted for greater ease of patients inorientating themselves relative to the straight line-of-sight member 29.

In operation, with the embodiment of the in-. vention as illustrated inFigures 1 to. 3, the person, or patient stands erect with one foot onone of the stationary supports H, i2 and the other on the adjustablesupport IS, with the toes slightly turned inwardly toward each other,slightly socalled pigeon toed. In this position, with the: limbconfronting the member 29 so that a verti-- cal line dropped through thepatella along the crest of the tibia is in horizontal alignment with,the straight line-of-sight provided-by the mem ber 29, as that memberitself or its extension the.

plumb 30, the plumb-bob 34, or the lower portion of the member 29 itselfshould be normally in the same vertical plane as the space between thethird and fourth toes, the plumb-bob 34 im mediately thereover. When theplumb-bob 34 is,

. however, medial to center, i. e., to the big toe side,

the operator after taking hold of the handle 22, and releasing the setscrew 25, turns the handle (to the right for the left foot, to the leftfor the right foot) until the tilting of the pan l3 elevates the medialside of the sole and heel of the foot sufficiently to bring the spacebetween the third and fourth toes into the vertical plane of theplumb-bob 34. The pointer turns over the. scale IE1, which is read,giving the degree or amount of elevation required. Partial lifts of theinVen-.

tion of my aforesaid copending application are then prescribed for, orfitted to, the outsole struc-' ture of the footwear of the person orpatient.

The height of the member 29 and its plumbbob are adjusted by the setscrews 35 and 36 to accommodate the height of the knee of the person orpatient.

In operation of the embodiment of the invention as illustrated inFigures 4 and 5, the pro- F cedure is the same, except the alignment iswith the upper and lower pointers 31, 38, and the knee of the person isclamped between the pads 46.

It will of course be understood that the invention in all its aspects isnot confined to the specific use hereinabove described, but much of theadvantage of the invention is attainable in co-relating other lines ofthe foot or limb, and may be, by obvious modification, of utility incorelating lines other than vertical, as for instance straight, butinclined lines, or in ascertaining alignment, or misalignment, inrespect of other abnormalities than so-called flat foot.

The invention as herein above set forth is embodied in a particular formand manner but may be variously embodied within the scope of thefollowing claims.

I claim:

1. Apparatus for determining the degree of postural foot disorder,comprising: oppositely disposed stationary support-surfaces and anadjustable pivotally mounted intermediate support all in the samehorizontal plane, for supporting a person standing thereon with normalstance with the sole of either foot on a said stationary surface whilethe sole of the other foot is on the adjustable intermediate support; amember providing a straight line-of-sight mounted in fixed relationrelative to said adjustable support with the straight line-of-sight inposition to confront 7 downwardly from the knee through the foot of thelimb of a person standing on the adjustable support; and actuating meansfor adjusting the intermediate support about its pivotal axis to aligna. predetermined portion of the foot with the. straight line-of-sight.

2. Apparatus for determining and indicating the degree of postural footdisorder, comprising: oppositely disposed stationary support surfacesand an adjustable pivotally mounted intermediate support all in the samehorizontal plane, for supporting a person standing thereon with normalstance with the sole of either foot on a said stationary surface whilethe sole of the other foot is on the adjustable intermediate support; amember providing a straight line-.of-sight mounted in fixed relationrelative to said adjustable support with the straight line-of-sight inposition to confront and correspond with a straight line projectingdownwardly from the knee through the foot of the limb of a personstanding on the adjustable support; actuating means for adjusting theintermediate support about; its pivotal axis to align a predeterminedportion of the foot with the straight, line-ofsight, and indicator meansfor indicating. the de gree of adjustment of the intermediate support bythe actuating means.

3; Apparatus as claimedin claim 1, and which includes adjustable meansfor holding the intermediate support and itsactuating means againstmovement under the. weight of the foot of a personv standing, thereon.

4. Apparatus as claimed in claim 1, and which the member providing a.straight line-of-sight includes an inner extension providing aline-ofsight reaching in closely to the shin bone for greater accuracyin. determining alignment.

5.. Apparatus as claimed in. claim l,v and in which the member providinga. straight line ofsight includes, a pendulent-plumb.

6. Apparatus as claimed in claim 1, in which the member providing astraight line-of-sight includes an inner extension providing aline-ofsight reaching in closely to the shin. bone for greater accuracyin determining alignment having. a plumb-bob at its lower end inposition to be-"closelyover the toes of a foot. on the: intermediatesupport, for greater accuracy in determining alignment.

'7. Apparatus as claimed in claim- 1-,, in which the member providing astraight line-of-sightincludesv upper and lower pointers reaching inclosely to the upper portion of the limb and over the toes of the footthereof on the intermediate support, for greater accuracyin determiningalignment.

8;. Apparatus as claimed in claim 1, andwhich includes a memberproviding adjustable knee. clamps mounted in fixed relation to theintermediate support and the straight line-of-sight, for firmly amxingthe limb in accurate relationship with respect to, the straightline-of-sight.

9. Apparatus for determining; the degree; of. postural foot disorder,comprising: anadjustablesupport mountedfor; adjustment about; a.horizontal axis,,and a stationary support. inithe-same horizontalplane,v for supporting a person in. standing position with the sole. ofc-nefoot; on the;

adjustable support and thesole of the otller'fnot.

on the stationary support; a straight line-of-sight member mountedperpendicular to; thefhQriZQ talaxis of the adjustable support, and inposi tion to be in. line with the front; of the, leg on:

8, the axis of the adjustable support, and means for adjusting theadjustable support, to adjust the foot of a person thereon relative tothe straight line-of-sight.

10. Apparatus as claimed in claim 9, and which includes indicating meansfor indicating the degree of adjustment made of the adjustable supportrelative to the straight line-of-sight member.

ll. Apparatus for determining the degree of postural foot disorder,comprising: an adjustable support mounted for adjustment about ahorizontal axis and a stationary support in the same horizontal plane,for supporting a person in standing position with the sole of one footon the adjustable support and the sole of the other foot on thestationary support; a straight line' of-sight member mountedperpendicular to the horizontal axis of the adjustable support, and inposition to be in line with the front of the leg on the adjustablesupport and in the same plane asthe axis of the adjustable support, andmeans for adjusting the adjustable support, to adjust the foot of aperson thereon relative to the straight line-of-sight, and in which thestraight line-ofsi'ght member includes an inner extension providing aline-of-sight reaching in closely to the shin bone for greater accuracyin determining alignment.

12 Apparatus as claimed in claim 9 and in whichthe straightline-of-sight member includes a pendulent-plumb.

13. Apparatus as claimed in claim 9, and. in which thestraight'line-of-sight member includes a pendulent-plumb having aplumb-bob at its lower end in position to be closely over the toes of afoot on the adjustable support, for greater accuracy. in determiningalignment.

14'. Apparatus for determining. the degree of postural foot. disorder,comprising: an adjustable support mounted for adjustment about ahorizontal axis and a stationary support in the same horizontal plane,for supporting a person in standing position with the sole of onefoot'on the adjustable support and the sole of the other footon thestationary support; a straight line-ofsight member mounted perpendicularto the horizontal axisof' the adjustable support, and inposition: to bein line with the front of the leg on the adjustable support andinthesame plane as theaxis of the adjustable support, and means foradjusting: the adjustable support, to' adjust the foot of a personthereon relative to the straight lineof-sight, and in which straightline-of-sight member includes upper and lower pointers reachhorizontalplane, for supporting a person in standing position/with the sole of onefoot on the adjustable support and the. sole of the other foot onthestationary support; a straightlineof-sight member'mounted perpendicularto the:

horizontal axisof the adjustable support, and in position to be in linewith the front of the leg:

on the adjustable supportand' in the same planeas the axis of theadjustablesupport, and means for adjusting the adjustable support, toadjust the foot of a person thereon: relative to the straightline-of-sight, and which includes a member providing adjustableknee-clamps mounted in fixed relation to the adjustable support and thestraight line-of-sight, for firmly aflixing the limb in accuraterelationship with respect to the straight line-of-sight.

REUBEN U. DARBY.

REFERENCES CITED The following references are of record in the file ofthis patent:

Numeer N umber 10 UNITED STATES PATENTS Name Date Stone Mar. 22, 1938FOREIGN PATENTS Country Date Germany June 22, 1882 Austria Jan. 10, 1911

